抗中性粒细胞胞浆抗体对自身免疫性肝炎的检测意义  

Detection of Anti-neutrophil cytoplasmic antibodies in Autoimmune hepatitis

作　　者：孔祥沙[1] 闫惠平[1] 廖慧钰[1] 赵艳[1] 冯霞[1] 檀玉芬[1] 刘秀红[1] 张海萍[1] 李俊强[1] 

机构地区：[1]首都医科大学附属北京佑安医院感染与免疫研究中心,100069

出　　处：《北京医学》2010年第12期947-950,共4页Beijing Medical Journal

基　　金：十一五传染病重大专项(2009ZX10004-309);北京市自然科学基金(7092046)

摘　　要：目的探讨抗中性粒细胞胞浆抗体(ANCA)对自身免疫性肝炎的检测意义。方法选择210例肝功能异常患者,其中自身免疫性肝炎(AIH)41例,原发性胆汁性肝硬化(PBC)19例,原发性硬化性胆管炎(PSC)3例,其他肝功能异常患者147例。应用间接免疫荧光法和免疫印迹法检测ANCA及其他相关自身抗体,并对患者临床资料进行分析比较。结果本组患者中,ANCA阳性16例,占肝功能异常患者的7.6%。16例ANCA阳性患者中AIH11例,PSC3例,慢性乙型肝炎1例,药物性肝损伤1例。41例AIH中,11例ANCA阳性(11/41,26.8%),同时伴有ANA阳性,核型以均质型为主(8/11,72.7%);30例ANCA阴性者中,25例ANA阳性,核型多样化,均质型仅占20.0%(6/30)。结论本研究中AIH中的ANCA阳性率仅为26.8%,以高滴度为主;ANCA阳性AIH患者ANA均阳性,其核型以均质型为主,且未观察到特殊的临床特征。Objective To know about the clinical significance of anti-neutrophil cytoplasmic antibodies（ANCA） in autoimmune hepatitis（AIH）.Methods Two hundred and ten patients with different liver disease were studied,41 were diagnosed autoimmune hepatitis,19 were primary biliary cirrhosis（PBC）,3 were primary sclerosing cholangitis（PSC）,147 were other liver diseases.210 patients with liver diseases were tested ANCA and other auto-antibodies by immunofluorescent assay（IFA） and immune blotting assay.Results Sixteen patients,7.6% of the 210 patients,were ANCA positive,of which 11 were with AIH（8 were AIH-Ⅰand 3 were AIH-Ⅱ）,3 with PSC,1 with hepatitis B,and 1 with drug induced liver disease.These 11 AIH patients with ANCA were all with ANA positive,of which mainly were homogeneous pattern by IFA.Twenty-five of the 30 AIH patients without ANCA showed various forms ANA,of with 6 were homogeneous.Conclusions The positive rate of ANCA in the patients with AIH,primarily with high titer,was 26.8%.Antinuclear antibodies（ANA） in these paitents,main pattem were homogeneous,were all positive.And we have not found specificity clinical features in these paitents.

关 键 词：自身抗体 自身免疫性肝炎 抗中性粒细胞胞浆抗体 

分 类 号：R575.1[医药卫生—消化系统]